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The use of colchicine as an anti-inflammatory agent for stroke prevention in patients with coronary artery disease: a systematic review and meta-analysis

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Abstract

Objective

The primary objective is to evaluate the use of colchicine as an anti-inflammatory agent for stroke prevention in patients with coronary artery disease.

Background

There has been a rising number of randomized controlled trials conducted in patients with coronary artery disease on the use of colchicine in reducing cardiovascular complications. Recent publications suggest colchicine reduces the risk of stroke and other cardiovascular events.

Methods

We performed a systematic review of known trials in the current literature to characterize the clinical characteristics and outcomes of colchicine treatment in patients with coronary artery disease. A literature search was performed in PubMed, Embase and SCOPUS using a suitable keyword search strategy from inception to 4 June 2021. All studies evaluating cardiovascular outcomes of colchicine treatment in patients with coronary artery disease were included.

Results

The systemic review included 5 randomized controlled trials assessing a total of 11,790 patients. Majority of studies used a colchicine dosing regimen of 0.5 mg once daily, with the median follow-up duration ranging from 6 to 36 months. Meta-analytic estimates for stroke incidence highlighted a statistically significant benefit for patients that were administered colchicine compared to placebo (OR 0.47, 95% CI 0.27–0.81, p = 0.006), and a non-significant benefit for myocardial infarction. There was no significant association between colchicine treatment and the adverse effects of gastrointestinal symptoms and myopathy/myalgia.

Conclusions

The use of colchicine reduces the risk of stroke in patients with a history of coronary artery disease, without a significant increase in gastrointestinal and myopathy/myalgia adverse effects.

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Availability of data and material

The data that support the findings of this study are openly available on Pubmed, Embase and SCOPUS.

Code availability

Not applicable.

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Acknowledgements

There are no non-contributing authors.

Funding

The work reported in this manuscript was not funded.

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Author notes

  1. Claire X. Y. Goh and Ying Kiat Tan are co-first authors.

Authors and Affiliations

  1. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore, Singapore

    Claire X. Y. Goh, Ying Kiat Tan, Natalie H. W. Tan, Sherill Goh, Vijay K. Sharma, Leonard L. L. Yeo & Benjamin Y. Q. Tan

  2. Department of Medicine, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore

    Choon Han Tan

  3. Division of Neurology, Department of Medicine, National University Health System, Singapore, Singapore

    Aloysius S. T. Leow, Vijay K. Sharma, Bernard P. L. Chan, Leonard L. L. Yeo & Benjamin Y. Q. Tan

  4. Academic Foundation Programme, North Middlesex University Hospital NHS Trust, London, UK

    Jamie S. Y. Ho

  5. Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore

    Andrew F. W. Ho

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  1. Claire X. Y. Goh
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Contributions

CXYG and YKT conducted the acquisition of data, analysis of said data and drafting of the report. CHT, ASTL, JSYH, NHWT, and SG provided guidance on both data collection and analysis, in addition to critically reviewing the report. AFWH, VKS, BPLC, LLLY were involved in the conception of the report, supervised data curation and revised the report critically for important intellectual content. BYQT formulated the research question and study design. He devised the search strategy, supervised data curation and revised the report critically for important intellectual content. All authors meet the ICMJE criteria for authorship and approve the final version. All authors agree to be accountable for all aspects of the work and for any issues relating to correctness or integrity of the work.

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Correspondence to Leonard L. L. Yeo.

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Goh, C.X.Y., Tan, Y.K., Tan, C.H. et al. The use of colchicine as an anti-inflammatory agent for stroke prevention in patients with coronary artery disease: a systematic review and meta-analysis. J Thromb Thrombolysis 54, 183–190 (2022). https://doi.org/10.1007/s11239-022-02659-9

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